A COMPARATIVE EVALUATION OF THE INDEX TESTING PROGRAM FOR MANICALAND AND MATABELELAND SOUTH PROVINCES, ZIMBABWE, 2022

Abstract

Background: Zimbabwe has been implementing Index contact tracing and testing (ICT) since 2019 to expedite epidemic control and accelerate the identication of people living with HIV. We identied two comparable provinces (structure, catchment, and location) yet with contrasting HIV prevalence rates to evaluate the program and develop recommendations that can enhance program performance. A process Methodology: evaluation of the ICT program was conducted in 8 randomly selected districts shared between Manicaland and Matabeleland South provinces. A logical framework model was applied to evaluate program inputs and processes, correlated with outputs and contributions toward outcomes. Microsoft Excel 2021 was used to summarize data as frequencies and proportions. W Results: e recruited 1,393 health workers over one year shared between Manicaland, 57.1% (n=795) and Matabeleland South 42.9% (n=598). An overall 80.6% (n=14,500) of the targeted Rapid test kits and 84.9% (n=24,200) of HIVST kits were supplied, resulting in intermittent shortages in both provinces. A copy of the ICT register was supplied per facility against an average of 3 entry points each. Manicaland conducted 33.5% of their targeted ICT trainings against 80% for Matabeleland. Program implementation was scored at 62.2% for Manicaland and 81.8% for Matabeleland South. Manicaland scored an HIVST reactivity rate of 7.7% (871/11,320) whilst Matabeleland South documented a reactivity rate of 6.2% (679/10,890) against a target of 10%. Both provinces scored above 60% of their target for the identication of HIV-positive individuals (Manicaland: 61.1%, Matabeleland South: 79.5%). An overall positivity yield of 62.8% (n=742/1,181) was obtained among index contacts. Index testing proved to be a resourc Conclusion: e-intensive HIV testing model yet highly effective in identifying individuals living with HIV among index contacts. The resource demand is justied by the high positivity yield which can be aided by implementation delity, critical to expediting epidemic control by mopping up clients living with HIV without the knowledge thereof.